Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis

Elena Minenna; Nada Chaoul; Maria Pia Rossi; Lucia Giliberti; Marcello Albanesi; Eustachio Nettis; Maria Pia Foschino Barbaro; Danilo Di Bona; Maria Filomena Caiaffa; Luigi Macchia

doi:10.5114/ada.2021.109586

eISSN: 2299-0046
ISSN: 1642-395X

Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii

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4/2022
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Letter to the Editor

Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis

Elena Minenna

^{1, 2, 3}

,

Nada Chaoul

³

,

Maria Pia Rossi

³

,

Lucia Giliberti

³

,

Marcello Albanesi

^{1, 3}

,

Eustachio Nettis

³

,

Maria Pia Foschino Barbaro

²

,

Danilo Di Bona

³

,

Maria Filomena Caiaffa

¹

,

Luigi Macchia

³

Department of Medical and Surgical Sciences, Chair of Allergology and Clinical Immunology, University of Foggia, Foggia, Italy

Department of Medical and Surgical Sciences, Chair of Respiratory Diseases, University of Foggia, Foggia, Italy

Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari – Aldo Moro, Bari, Italy

Adv Dermatol Allergol 2022; XXXIX (4): 816-818

DOI: https://doi.org/10.5114/ada.2021.109586

Online publish date: 2021/10/01

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AMA

Minenna E, Chaoul N, Pia Rossi M, et al. Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2022;39(4):816-818. doi:10.5114/ada.2021.109586.

APA

Minenna, E., Chaoul, N., Pia Rossi, M., Giliberti, L., Albanesi, M.,  & Nettis, E. et al. (2022). Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(4), 816-818. https://doi.org/10.5114/ada.2021.109586

Chicago

Minenna, Elena, Nada Chaoul, Maria Pia Rossi, Lucia Giliberti, Marcello Albanesi, Eustachio Nettis,  and Maria Pia Foschino Barbaro et al. 2022. "Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 39 (4): 816-818. doi:10.5114/ada.2021.109586.

Harvard

Minenna, E., Chaoul, N., Pia Rossi, M., Giliberti, L., Albanesi, M., Nettis, E., Foschino Barbaro, M., Bona, D., Caiaffa, M.,  and Macchia, L. (2022). Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(4), pp.816-818. https://doi.org/10.5114/ada.2021.109586

MLA

Minenna, Elena et al. "Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 39, no. 4, 2022, pp. 816-818. doi:10.5114/ada.2021.109586.

Vancouver

Minenna E, Chaoul N, Pia Rossi M, Giliberti L, Albanesi M, Nettis E et al. Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2022;39(4):816-818. doi:10.5114/ada.2021.109586.

Low molecular weight heparins (LMWHs), particularly enoxaparin, are administered routinely to Coronavirus disease 2019 (COVID-19) patients, in order to treat or prevent the associated, possibly serious coagulation disorders [1].

Both immunoglobulin E (IgE)-mediated and non IgE-mediated systemic reactions to LMWHs are considered rare [2–4]. Particularly, a single case of the drug-related reaction with eosinophilia and systemic symptoms (DRESS) has been documented in the literature [4].

Here we report on an elderly COVID-19 patient who developed DRESS upon prophylactic treatment with enoxaparin. Etiological diagnosis was corroborated by the lymphocyte proliferation test (LPT) [5] upon recovery. The management strategy adopted is outlined and commented.

Sustained drug-related reaction with eosinophilia and systemic symptoms (DRESS) triggered by low molecular weight heparins in COVID-19: management and precision diagnosis

Elena Minenna 1, 2, 3 , Nada Chaoul 3 , Maria Pia Rossi 3 , Lucia Giliberti 3 , Marcello Albanesi 1, 3 , Eustachio Nettis 3 , Maria Pia Foschino Barbaro 2 , Danilo Di Bona 3 , Maria Filomena Caiaffa 1 , Luigi Macchia 3

Elena Minenna

^{1, 2, 3}

,

Nada Chaoul

³

,

Maria Pia Rossi

³

,

Lucia Giliberti

³

,

Marcello Albanesi

^{1, 3}

,

Eustachio Nettis

³

,

Maria Pia Foschino Barbaro

²

,

Danilo Di Bona

³

,

Maria Filomena Caiaffa

¹

,

Luigi Macchia

³